Provider Demographics
NPI:1538389515
Name:ACORN PODIATRY CENTER LTD
Entity type:Organization
Organization Name:ACORN PODIATRY CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FINN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:708-848-8014
Mailing Address - Street 1:1144 LAKE ST
Mailing Address - Street 2:202
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-6705
Mailing Address - Country:US
Mailing Address - Phone:708-848-8013
Mailing Address - Fax:708-848-8354
Practice Address - Street 1:1144 LAKE ST
Practice Address - Street 2:202
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-6705
Practice Address - Country:US
Practice Address - Phone:708-848-8013
Practice Address - Fax:708-848-8354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2011-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016003835213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016003835Medicaid
IL016003835Medicaid
ILCF4218Medicare PIN
IL1045620001Medicare NSC
ILIL2576Medicare PIN
IL771030Medicare PIN